【摘要】 目的比较不同方法治疗高血压脑出血的疗效,以寻求最佳治疗方法。方法将我院自2000年1月~2005年4月收治的高血压脑出血患者254例简单随机分为微创血肿腑吸术组、微创血肿引流术组和内科治疗组。根据配对条件对204例患者按1∶1配对研究,分别行微创血肿碎吸术和内科治疗。微创血肿碎吸术中50例患者与50例微创血肿引流术患者对比。微创血肿碎吸术组和微创血肿引流术组根据头部CT显示血肿的不同情况进行穿刺手术。内科治疗组以药物治疗为主。结果微创血肿碎吸术组和内科治疗组患者治疗后临床神经功能缺损程度评分(CNIS)别是17.53±12.33与32.76±9.83,差异有显著性意义(P<0.01);微创血肿碎吸术组和微创血肿引流术组患者治疗后CNIS分别是16.38±11.25与25.39±10.31,差异有显著性意义(P<0.01)。随访存活患者日常生活能力(ADL),分ADL1-2级、ADL3-4级、ADL5级,微创血肿碎吸术和内科治疗对照组及微创血肿碎吸术和微创血肿引流术对照组间差异均有显著性意义(P<0.01)。随访病死率两对照组间差异有显著性意义(P<0.01)。结论临床观察及随访表明微创血肿碎吸术疗效优于内科治疗及微创血肿引流术。更多还原

【Abstract】 Objective To compare with the different therapeutic means as to find optimal treatment. Methods Patients with hypertensive inter-cerebral hemorrhage accepting therapy in our hospital were divided into three groups: one group with minimally invasive surgery crashing and aspirating hematoma, one with conservative treatment, one group with minimally invasive surgery draining hematoma. Among them, 254 patients was studied by matched-pair, one compared one, according to matched-pair conditions. The group with minimally invasive surgery crashing and aspirating hematoma and conservative treatment had 102 pairs. 50 among 102 patients accepting minimally invasive surgery crashing and aspirating hematoma was compared to 50 patients accepting minimally invasive surgery draining hematoma. The patients accepting surgery were punted according to different hematoma information in computed tomography(CT). The patients in conservative treatment group were treated by drugs. Results The clinical neurological deficient scale showed significant differences between the groups of minimally invasive surgery crashing and aspirating hematoma and the conservative treatment groups (P<0.01), clinical neurological impairment scores(CNIS) were 17.53±12.33 and 32.76±9.83 respectively; Being significantly different between the groups of minimally invasive surgery crashing and aspirating hematoma and the groups of minimally invasive surgery draining hematoma(PM0.01). CNIS were 16.38±11.25 and 25.39±10.31 respectively. In following-up study, the number of survival patients having 1~2 grade on activities of daily life(ADL1-2), ADL3-4 and ADL5 were significantly different between two comparative groups (P<0.01), and the mortalities were also (P<0.01). Conclusions It is obvious that the benefit of minimally invasive surgery crashing and aspirating hematoma should be better than that of the conservative treatment and of minimally invasive surgery draining hematoma, through the clinical observation and the following-up study.更多还原